| NPI | 1235589045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501004623) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 25210) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2018-03-17 |